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植入前遗传学诊断显著改善了有反复流产和妊娠失败病史的易位携带者的妊娠结局。

Preimplantation genetic diagnosis significantly improves the pregnancy outcome of translocation carriers with a history of recurrent miscarriage and unsuccessful pregnancies.

作者信息

Otani Tetsuo, Roche Muriel, Mizuike Miho, Colls Pere, Escudero Tomas, Munné Santiago

机构信息

Otani Women's clinic, Kobe, Japan.

出版信息

Reprod Biomed Online. 2006 Dec;13(6):869-74. doi: 10.1016/s1472-6483(10)61037-1.

Abstract

Preimplantation genetic diagnosis (PGD) for translocations has been shown to significantly reduce the risk of recurrent miscarriage, but because the majority of embryos produced are unbalanced, pregnancy rate is relatively low since 20% or more cycles have no normal or balanced embryos to transfer. The purpose of this study was to evaluate whether PGD could improve pregnancy outcome in translocation carriers with a history of two or more consecutive miscarriages and no live births. PGD for translocations was offered to translocation carriers with two or more previous miscarriages (average 3.5) and no live births (0/117 pregnancies) using a combination of distal and proximal probes to the breakpoints. After PGD, only 18.3% of embryos were normal or balanced. Only 5.3% of pregnancies were lost after PGD compared with 100% before PGD (P < 0.001). The cumulative pregnancy rate was 57.6% and the cumulative ongoing pregnancy rate was 54.5% in the short period of time of 1.24 IVF cycles, or 46.3% and 43.9% respectively per cycle. In conclusion, PGD significantly reduced losses and increased the number of viable pregnancies (P < 0.001). IVF plus PGD are a faster method of conceiving a live child than natural conception, at least for translocation carriers with recurrent miscarriages and no previous live births.

摘要

针对易位的植入前基因诊断(PGD)已被证明可显著降低反复流产的风险,但由于产生的大多数胚胎是不平衡的,妊娠率相对较低,因为20%或更多的周期没有正常或平衡的胚胎可供移植。本研究的目的是评估PGD是否能改善有两次或更多次连续流产且无活产史的易位携带者的妊娠结局。使用针对断点的远端和近端探针组合,为有两次或更多次既往流产(平均3.5次)且无活产(117次妊娠中0次活产)的易位携带者提供针对易位的PGD。PGD后,只有18.3%的胚胎是正常或平衡的。PGD后只有5.3%的妊娠丢失,而PGD前为100%(P<0.001)。在1.24个体外受精周期的短时间内,累积妊娠率为57.6%,累积持续妊娠率为54.5%,或每个周期分别为46.3%和43.9%。总之,PGD显著减少了妊娠丢失并增加了存活妊娠的数量(P<0.001)。体外受精加PGD是一种比自然受孕更快的生育活产婴儿的方法,至少对于有反复流产且无既往活产史的易位携带者来说是这样。

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